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Lipoedema affects up to 10% of Australian women*, yet it’s still frequently misdiagnosed as obesity, cellulite, or other conditions with similar symptoms.
Having a special interest in lipoedema treatment and years of experience supporting people living with the condition, I see firsthand the frustration of patients who have gone too long with too few answers.
ON THIS PAGE
- What is lipoedema?
- How doctors diagnose lipoedema
- Key symptoms to watch for
- Treatment options
- When to see your GP
- About Dr Jackie Fankhauser
If you’ve ever walked out of a medical appointment feeling unheard and no closer to understanding your symptoms, you’re not alone.
My hope is that today marks a turning point for you.
With a proper assessment, there’s every chance we can confirm whether you have lipoedema and begin guiding you toward treatments to ease your discomfort and improve your quality of life.
* Though I’ve used a cisgender context to discuss this complex area of medicine, I recognise and appreciate that not all people identify with binary genders.
What is Lipoedema?
Lipoedema is a chronic, often painful inflammatory condition that mostly affects women.
It causes abnormal fat deposits (adipose tissue) to build up beneath the skin, typically in the legs and arms.
The condition occurs symmetrically on both sides of the body.
Lipoedema affects everyone differently. Some people have mild discomfort or are concerned about how it looks.
For others, it can make movement difficult and significantly affect daily life and mental health.
We’re still not 100% clear on the causes, but genetics, a family history of lipoedema, and hormonal changes are likely to blame.
It’s not unusual for me to diagnose lipoedema in people during times of hormonal changes. This includes pregnancy, perimenopause, or when starting or adjusting medications like hormone replacement therapy (HRT) and the contraceptive pill.
How Do Doctors Diagnose the Condition?
There’s no specific blood or pathology test for lipoedema.
Instead, experienced GPs gather diagnostic information through a physical examination and a detailed medical history, including whether any family members have had the condition.
In many cases, I can quickly determine if lipoedema is present.
Below, I’ve summarised the main conditions I look to exclude.
Lymphoedema
Lymphoedema develops when the lymphatic system isn’t working properly, leading to fluid buildup in the tissues and noticeable swelling in the limbs. Unlike lipoedema, it can also involve the hands and feet.
It may appear in a single leg, and when both legs are involved, the swelling is usually asymmetric.
Significantly, untreated lipoedema can progress to lymphoedema. Up to 50% of patients with lipoedema may also have lymphoedema.
Chronic Venous Insufficiency (CVI)
Mostly seen in older adults, CVI symptoms include swelling and heaviness in the lower leg and ankle, aches and pains, and varicose veins.
Skin changes, such as discolouration or ulceration, are typical of CVI. In contrast, lipoedema more often causes easy bruising rather than persistent skin changes.
Heart Failure
Swelling in the legs, ankles, and feet is a common sign of heart failure.
Because sudden weight gain can also be a symptom, it’s understandable that people with lipoedema may fear heart failure is lurking in the background.
Common Lipoedema Symptoms
As with many chronic conditions, symptoms can vary widely from person to person. Common signs of lipoedema include:
- Excess fat in the legs that is disproportionate to the rest of the body
- Swelling in the legs
- Aches, tenderness, or pain, with skin that’s sensitive to touch
- Pain during or after exercise
- Reduced mobility or difficulty walking
- Easy bruising
- Bumpy, dimpled, or “orange-peel” skin texture
- Vascular changes, including varicose veins, spider veins, or skin colour changes
Lipoedema is a progressive condition, meaning the fatty tissue can continue to build up over time if left untreated.
Symptoms often shift as the condition progresses. Secondary symptoms may also develop, further complicating living with the condition.
When needed, we can also address related mental health concerns, joint problems, and lymphatic issues.
Lipoedema Treatment Options
Lipoedema treatment focusses on managing symptoms and reducing their impact on your daily life.
To tailor the best treatment plan for you, I’ll consider your specific diagnosis, how advanced the condition is, and your overall health.
Non-Surgical Treatments
I usually recommend starting with conservative, non-invasive treatments before exploring surgical options. There are several helpful approaches:
- Compression therapy: Medical-grade compression garments can reduce swelling and discomfort. A physiotherapist or occupational therapist trained in lipoedema and lymphoedema can help you measure for compression garments and advise on their correct use. I can provide you with a referral.
- Manual lymphatic drainage: Regular, gentle massage can support lymphatic flow, reduce swelling, and relieve pain.
- Pneumatic compression pumps: These devices simulate natural lymphatic drainage and are most effective when used in conjunction with compression garments.
- Low-carbohydrate diet: Low-carb diets are known to be anti-inflammatory and can help with pain and swelling. I can arrange a referral to a dietitian experienced in treating patients with lipoedema for you.
- Regular exercise: Low-impact activities such as swimming and cycling can improve mobility and help manage symptoms; however, it is also important to build and maintain muscle strength. An exercise physiologist or physiotherapist can help tailor programs to your circumstances.
I’m also here to support you with any mental health challenges that may arise as you navigate this condition.
Medications
People with lipoedema increasingly use semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro) for weight loss and maintenance.
These medications have also been shown to be anti-inflammatory and can help with pain and swelling that often come with the disease.
Lipoedema Liposuction
While surgery can help reduce the severity of lipoedema symptoms and provide meaningful relief, it’s not a cure.
The most common surgical approach is specialised tumescent liposuction.
This technique is designed to minimise bruising, swelling and bleeding compared with standard liposuction. In some cases, your surgeon may also remove excess skin as part of the procedure.
Currently, Medicare does not cover liposuction for lipoedema.
Weight Loss Surgery
If your body mass index (BMI) is above 35, I may suggest exploring weight loss (bariatric) surgery to help you manage and maintain your weight.
Obesity can worsen lipoedema, and managing weight effectively can play an essential role in reducing symptom severity.
When to Visit Your GP
It’s important to seek medical care if you’re experiencing any of the symptoms described above.
Lipoedema Australia provides a helpful ‘Notes for Your GP Consult’ checklist that you can print, complete, and bring to your appointment. It’s a great way to summarise your symptoms and ensure nothing is overlooked.
Rest assured, seeing an experienced GP who takes your concerns seriously—and won’t fob off your symptoms—can be the first step toward the relief you’ve been waiting for.
Dr Jackie Fankhauser (MBBS Hons., FRACGP, BSpPath) is a local GP at Doctors of South Melbourne.
Along with having special interests in lipoedema and women’s health, she’s a regular expert guest on the ever-popular Lipoedema Podcast.
You can make an appointment online with Jackie or call us on (03) 8579 6838.
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